I'm near rock bottom, please help. Labs attached

[togeprrriii]

hemoglobin & ferritin still up but transferrin saturation low Normal Ferritin in a Patient with Iron Deficiency and RLS.

The patient in this case study indeed has iron panel levels very similar to myself: low serum iron, below range transferrin saturation, low to mid-normal ferritin and mid-normal iron binding capacity.
Edit: ... and they treated her with ferrous ulfate, 2X 325mg per day. After six weeks, most notably transferrin saturation went up to 39% (from 9% before the intervention) - that's big. Yet I'm unsure if I should take iron. I think I'll stick with the advice here first, fixing the low folate / high homocysteine and having a daily supply of the b-vitamins. And getting copper / ceruloplasmin up.

 

[youngsinatra]

I think 500-1000mg of B5 are used for adrenal fatigue.

Are you feeling worse with cortisol-lowering substances ? (like magnesium or zinc)

I think fixing the low ceruloplasmin is the key thing to fix your low iron labs. Without it, you cannot manage and utilize iron. Some gentle methylation support (B2, folate), getting down the reverse T3 (and by that increasing the relative amount of free T3) and supporting the adrenals will likely help with increasing ceruloplasmin.


View: https://youtu.be/nUfhIM6thI8?si=Mev8BUGNyY7PUprw

 

[cs3000]

The patient in this case study indeed has iron panel levels very similar to myself: low serum iron, below range transferrin saturation, low to mid-normal ferritin and mid-normal iron binding capacity.
Edit: ... and they treated her with ferrous ulfate, 2X 325mg per day. After six weeks, most notably transferrin saturation went up to 39% (from 9% before the intervention) - that's big. Yet I'm unsure if I should take iron. I think I'll stick with the advice here first, fixing the low folate / high homocysteine and having a daily supply of the b-vitamins. And getting copper / ceruloplasmin up.

that much iron can damage the gut a lot, the other 2 forms are safer if gonna supplement but i wouldnt like to take a lot. Yeah good approach at least at first is trying to fix the surrounding things & having dietary intake > what body loses daily.
copper supplements dont look useful. liver is a good source of copper (*important - as long as you dont have high vit a levels), maybe through the vit a (if in balance) helping ATP7A which is what intestinal cells need expressed to absorb copper , if you fix low vit a levels it raises ceruloplasmin levels through copper absorption https://www.sciencedirect.com/science/article/abs/pii/S0022316623083426 , BUT if you overload with high vit a levels it has the opposite effect The effect of different dietary levels of vitamin A on metabolism of copper iron and zinc in the chick - PubMed
you get some zinc from liver though but beef liver has highest copper - zinc ratio so only a little if you eat right amount Foods Highest in Copper and Lowest in Zinc. eating too much copper at once instead of spread out might be overly mentally stimulating is for me

also in general if your iron is low then dietary copper absorption should be good to raise ceruloplasmin i think https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fasebj.26.1_supplement.243.8 -> iron deficiency raises atp7a for more copper absorption. same thing that t3 hormone does (but idk if t3 works for increasing expression if not getting into cell due to low iron, t3 might already be up?). if copper absorption isnt good with low iron then can be an issue with high vit a , or low SP1 which is needed for the atp7a increase. biotin is something that raises sp1 so could indicate low biotin.
(for the b5 i remember ray said high doses were well tolerated in monkeys. saw a study where its helpful for myelin repair in the brain. and helps progesterone too Effects of pantothenic acid supplementation on adrenal steroid secretion from male rats - PubMed but does mention "hyperresponsiveness to ACTH stimulation" after 9 weeks so wary of tipping over to the other side with excess cortisol. you would probably know if noticed more hair loss from it)

 

[togeprrriii]

Are you feeling worse with cortisol-lowering substances ? (like magnesium or zinc)

I'm not sure as I never checked into my body for it. I generally find it hard to detect effects from supplements, to be honest. I may have been unlucky in selecting stuff, e.g. I thought magnesium is one of the substances one should take in addition to food because the modern body needs it and/or foods don't contain enough. Plus, didn't Ray say that hypothyroid people lose magnesium quickly? Yet, my mag blood levels are above range, indicating an overload and imbalance with some other minerals. And I'm sure that I am not only hypocortisol but also functionally/cellularly hypothyroid.

When I was taking 25mcg of T3 the other day as a test, it didn't affect me much I think. Didn't take temps or pulse. But I didn't feel a change. I wonder if I might have resistance to thyroid hormone, and if those free fatty acids - which are elevated - and predominant fatty acid oxidation - which I suspect - are blocking T3 in the cells. At least PUFA are known to do this. That's one of my line of thinking/intervening right now. If a significant portion of my free floating fatty acids are PUFA then that could be a cause for poor T3 function in the cells, even with additional T3 supplementation, right? So blocking lipolysis and/or FAO seem to be a possible or maybe necessary route to help T3 to do its work again.

 

[togeprrriii]

that much iron can damage the gut a lot, the other 2 forms are safer if gonna supplement but i wouldnt like to take a lot. Yeah good approach at least at first is trying to fix the surrounding things & having dietary intake > what body loses daily.
copper supplements dont look useful. liver is a good source of copper (*important - as long as you dont have high vit a levels), maybe through the vit a (if in balance) helping ATP7A which is what intestinal cells need expressed to absorb copper , if you fix low vit a levels it raises ceruloplasmin levels through copper absorption https://www.sciencedirect.com/science/article/abs/pii/S0022316623083426 , BUT if you overload with high vit a levels it has the opposite effect The effect of different dietary levels of vitamin A on metabolism of copper iron and zinc in the chick - PubMed
you get some zinc from liver though but beef liver has highest copper - zinc ratio so only a little if you eat right amount Foods Highest in Copper and Lowest in Zinc. eating too much copper at once instead of spread out might be overly mentally stimulating is for me

also in general if your iron is low then dietary copper absorption should be good to raise ceruloplasmin i think https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fasebj.26.1_supplement.243.8 -> iron deficiency raises atp7a for more copper absorption. same thing that t3 hormone does (but idk if t3 works for increasing expression if not getting into cell due to low iron, t3 might already be up?). if copper absorption isnt good with low iron then can be an issue with high vit a , or low SP1 which is needed for the atp7a increase. biotin is something that raises sp1 so could indicate low biotin.
(for the b5 i remember ray said high doses were well tolerated in monkeys. saw a study where its helpful for myelin repair in the brain. and helps progesterone too Effects of pantothenic acid supplementation on adrenal steroid secretion from male rats - PubMed but does mention "hyperresponsiveness to ACTH stimulation" after 9 weeks so wary of tipping over to the other side with excess cortisol. you would probably know if noticed more hair loss from it)
View attachment 56954

I can'T eat liver now. I'm not able to cook for myself as I feel to weak and crash from a little too much physical exertion, which preparing a meal at the end of the day is for me at the moment. And I don't want to take liver supps. So wouldn't retinyl palmitate and copper glycinate be a good enough alternative for raising ceruloplasmin levels?

 

[togeprrriii]

To everyone replying so far and watching thsi thread, thanks a lot. I will post my plan regarding supplements etc. in another post maybe tomorrow.

I added one more lab sheet, forgot it in the OP. All these are tested in urine. Dunno, maybe there's some value in addressing neurotransmitters and catecholamines, too, to help restore energy?
More context to better interpret these labs: Remember I used venlafaxine on/off since 2020. Approx. 20-30% of the time I was on it, between 75 and 187.5mg. Also I might have some ADHD-like personality, as I have always been a dopamine chaser, kind of impulsive, prone to obsessive/hyperfocus-like behaviour and also to addictive behaviour (never "real" addiction though). At the same time introverted/sensitive, so prone to stress and being overwhelmed by too much stimulation. So in essence a very contradictive personality neurologically speaking. I think it's also one of the main drivers of my burnout in 2016 and prolonged condition until this day. I'm burning my ressources quickly, and I guess this manifests in all those low neurotransmitters.

Thoughts still welcome!

 

[cs3000]

I can'T eat liver now. I'm not able to cook for myself as I feel to weak and crash from a little too much physical exertion, which preparing a meal at the end of the day is for me at the moment. And I don't want to take liver supps. So wouldn't retinyl palmitate and copper glycinate be a good enough alternative for raising ceruloplasmin levels?

i looked into it some more yesterday , copper supps work about 50% of the time , probably based on individual absorption of copper itself rather than it being a problem with supplements. im aiming to get my copper up & doing a mix of food and a little copper citrate (will take just a little bit of the supplement through the day probably no more than 0.25mg-0.5mg at a time to avoid overstimulation), aiming for ~2mg - 3mg total initially

some vit a & vit d to increase uptake & export, (but not too much depends on individual balance so its hard to say - i wouldn't take more than 3000iu vit a and only if levels aren't high compared to vit d), going on a low zinc diet for now, keeping low magnesium diet too for now to avoid more copper wasting,

other food sources high in copper: cocoa if can tolerate the stimulants (weirdly low amounts needed compared to other studies [Copper supplement with cocoa for copper deficiency in patients with long-term enteral nutrition] - PubMed), spirulina (if safe source not contaminated) , beans but the ones high in raffinose cause gas and in general they might inhibit thyroid idk

To everyone replying so far and watching thsi thread, thanks a lot. I will post my plan regarding supplements etc. in another post maybe tomorrow.

I added one more lab sheet, forgot it in the OP. All these are tested in urine. Dunno, maybe there's some value in addressing neurotransmitters and catecholamines, too, to help restore energy?
More context to better interpret these labs: Remember I used venlafaxine on/off since 2020. Approx. 20-30% of the time I was on it, between 75 and 187.5mg. Also I might have some ADHD-like personality, as I have always been a dopamine chaser, kind of impulsive, prone to obsessive/hyperfocus-like behaviour and also to addictive behaviour (never "real" addiction though). At the same time introverted/sensitive, so prone to stress and being overwhelmed by too much stimulation. So in essence a very contradictive personality neurologically speaking. I think it's also one of the main drivers of my burnout in 2016 and prolonged condition until this day. I'm burning my ressources quickly, and I guess this manifests in all those low neurotransmitters.

Thoughts still welcome!

low dopamine function can contribute to addictive behaviour (as baseline experience is unengaged so shift more towards extremes to get some activation). but then the extreme overstimulation causes more brain damage like u mentioned with even lower function, so that can create a loop. am the same. i often burn out on stuff hyperfocusing to death if not careful paradoxically even if fatigued. low brain iron is 1 thing that lowers dopamine function a lot, folate needed for neurotransmitters too. i think through S-adenosylmethionine
the flavonoid "nobiletin" could be something helpful for excess glutamate activity, if that test correlates with brain levels. but too many flavonoids can affect copper

 

[youngsinatra]

Low neurotransmitters, very high homocysteine, low ceruloplasmin all indicate problems with methylation to me.

I‘d rather focus on riboflavin and methylfolate, maybe some B12. (even tho I prefer food sources for that)

Of course, the adrenal/thyroid axis needs to be adressed, because B2 cannot be activated without a well-functioning thyroid.

Low ceruloplasmin oftentimes do not resolve with copper or eating liver unfortunately. Thyroid, adrenals, stress management, methylation all needs to be adressed.

We know that adrenal hormones influence ceruloplasmin levels since the 1970s. I can attach some papers later.

 

[youngsinatra]

Sorry if you already talked about it, but have you ever tried pregnenolone? Ray said it’s good for the adrenals and iirc even helpful for people with adrenal insufficiency.

 

[togeprrriii]

Sorry if you already talked about it, but have you ever tried pregnenolone? Ray said it’s good for the adrenals and iirc even helpful for people with adrenal insufficiency.

Yes, I supplemented with 50mg Preg per day for 2 weeks or so in late Augst. Maybe that is what contributes to my above normal preg lab value (17-hydroxy pregnenolone or some like that).

I would like to try hydrocortisone (and maybe DHEA) in hopes of stabilising me. And then build from there, trying T3. But I'm also a bit afraid of possible damage. I already feel some light stinging in left chest, maybe the heart. I get adrenaline surges a lot I think when I research stuff on the internet, because I am so desperate to find some solutions. I already drink juice every 3 hours, take salt, upped Thiamine to 2x 100mg, B6 P5P to 5mg, riboflavin R5P 10mg, additional medium dosed b-complex, sodium ascorbate, 1x 450mg pantethine (form of b5), copper glycinate 6mg and now finally my folate arrived and I start taking that also. But I often get kind of jittery feelings all over my body, limbs, and exhaustion pain (like when I was a child after a long playful or stressful day) in the muscles i guess. also kind of pressure under stress in my throat below the larynx, maybe where the thyroid gland is. and i still dont know what all these symptoms mean.

I have not yet tried niacinamide or aspirin. these are routes of some hope to me at the moment, as i am theorizing that my body seems stuck, congested. maybe stuck in glycolysis and i have to try bring it to krebs and electron transport chain? only little physical exertions cause almost immediate ache/exhaustion/weakness/twitching reactions (all at once or in some combination) in my muscles, and also my stress hormones seem to have a hard time keeping up with that. sometimes i feel air hungry and need to lay down and the body forces deep breaths from me. and when i drink OJ or other fruit juice it seems that my battery only recharges to 10 or 15%, at best. so when i am without stress, trying to replenish my body, and then go under some minor stress like walking stairs or lifting stuff (1kg maybe), I can only do that for some seconds and then i get a stress response, feel weak, get aches etc as if my body either uses up the carbs very quickly and/or inefficiently, or the ingested sugar hardly gets used for fuel at all bc of possible insulin resistence.

I dont know what to do, but i guess i need some intervention because just by relaxing and taking short walks i only get little improvement and there seems to be some underlying **** that might not get better by laying back.

Edit: By the way, i took temps in the past couple days. morning basal temp is 36.2 or 36.3, throughout the day it rises to between 36.5 and 36.7 on average. under (minor) stress it even rises up to 37 when at the same time i feel bad. when i was outdoors for an hour the other day (just light walking and sitting on a bench at cool autumn temperatures), my temp went down to 36.1 after that. when i drank fruit juice, the first 15 minutes or so after finishing my temps also fall to around 36.1 to 36.2, but after 30-40 minutes they go up to near 37.